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Medical Biller, Credentialing Specialist

Company: CNS Healthcare
Location: Waterford
Posted on: May 3, 2021

Job Description:

What we are looking for:The Credentialing Specialist is responsible for gathering and verifying highly confidential and sensitive health provider information and needs to be highly organized and have meticulous attention to detail to be successful in this role. Excellent verbal and written communication skills are also crucial as this position spends a significant portion of its time communicating with administrative staff, healthcare staff, medical practitioners, government agencies, and insurance representatives.Our ideal candidate would have a medical billing and credentialing background and strong communication and organizational skills. Experience with the community mental health system is helpful, as well as experience with navigating an EHR.What's in it for you:We serve individuals living with behavioral health and substance use issues. As a member of our team, you will have an opportunity to make a meaningful impact on our community and the lives of the people we serve by supporting our front line workers and clinicians.CNS Healthcare provides a generous total rewards program to support our team members including: a 403(b)-retirement plan with company match; comprehensive medical, dental and vision insurance; employer sponsored life insurance; short- and long-term disability insurance; PTO; paid parental leave; Employee Assistance Program; tuition reimbursement; and much more!Behavioral health services are needed now more than ever, offering our team members a secure job and opportunities to grow alongside CNS Healthcare.Have an opportunity to join one or more of our committees to help shape the future of our organization including our Cultural Diversity, Equity and Inclusion Committee; our LGBTQIA+ Committee and more!Interested in learning more about this role?See below for a summary of job responsibilities and qualifications!Coordinate the credentialing application process by sending, receiving, and analyzing provider documents and information to ensure accuracy and completenessPerform all aspects of credentialing verification, including the initial credentialing process and recredentialingMonitor and follow-up on provider credentialing and recredentialing applications as needed to ensure timely and accurate processingMonitor and notify appropriate parties of expiring licensure, board, and professional certifications and other expirable documents with providersEnsure agency and provider information is current with all health plans, agencies, and other entitiesCompile and maintain an accurate recordkeeping system to ensure the integrity of credentialing information and documents in applicable databasesMaintain agency provider contract filesCoordinate and collaborate with providers, department leadership, human resources, and external agencies to facilitate the credentialing processConduct follow-ups with individual providers and other internal/external entities to resolve any discrepancies or issues identified during the credentialing processRespond to all provider, health plan, agency, and internal inquires in a timely mannerMaintain knowledge of current health plan and agency requirements for credentialing providersPerforms other duties as assignedQualificationsEducation: High School Diploma or equivalent (additional college level course preferred).Experience: Two years of medical biller, credentialing, or similar role required; one year of working in a behavioral health setting preferredKnowledge: Working knowledge of the credentialing process is required;Customer Service: A passion for providing an unparalleled customer service experience required.Technology: Basic level word processing and telephone skills required; Experience with Microsoft products preferred; Experience with an EHR preferredOther: Ability to work closely with persons with mental or physical disabilities required; Ability to be flexible with one's work schedule requiredTransportation: Must have a valid Michigan Driver's License and a vehicle available for work purposes with current unrestricted (state of Michigan) auto insurance required Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Keywords: CNS Healthcare, Waterford , Medical Biller, Credentialing Specialist, Other , Waterford, Michigan

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